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Chronic Obstructive Pulmonary Disease

Management of Chronic Obstructive Pulmonary Disease in Adults in Primary and Secondary Care

NICE Clinical Guidelines, No. 101

National Clinical Guideline Centre (UK).

Copyright and Permissions


This guideline offers best practice advice on the identification and care of patients with chronic obstructive pulmonary disease (COPD). It aims to define the symptoms, signs and investigations required to establish a diagnosis of COPD. It also aims to define the factors that are necessary to assess its severity, provide prognostic information and guide best management. It gives guidance on the pharmacological and non-pharmacological treatment of patients with stable COPD, and on the management of exacerbations. The interface with surgery and intensive therapy units (ITU) are also discussed.


The guideline was first published in February 2004 and updated and published in June 2010. Original guideline publish 2004 is copyright to © 2004 Royal College of Physicians of London.

Note to stakeholders:

The Guideline Development Group wish to point out that this is a partial update of an existing guideline, with the integration of new sections into the old publication. This has inevitably led to inconsistencies in style, particularly where new tables and forest plots have been inserted alongside old-style evidence statements, and also where new recommendations (without any gradings) have been added to, or replaced, existing recommendations which do have gradings.

The expanded section on Inhaled Therapy (which now incorporates the previous separate sections on Inhaled Bronchodilators, Inhaled Corticosteroids and Inhaled Combination Therapy) now concludes with a number of new recommendations which have all been grouped together for ease of reference, although this has necessitated their being somewhat removed from their supporting evidence.

Suggested citation:

National Clinical Guideline Centre. (2010) Chronic obstructive pulmonary disease: management of chronic obstructive pulmonary disease in adults in primary and secondary care. London: National Clinical Guideline Centre

Copyright © 2010, National Clinical Guideline Centre - Acute and Chronic Conditions.

Apart from any fair dealing for the purposes of research or private study, criticism or review, as permitted under the Copyright, Designs and Patents Act, 1988, no part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page. The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore for general use. The rights of National Clinical Guideline Centre to be identified as Author of this work have been asserted by them in accordance with the Copyright, Designs and Patents Act, 1988.

PMID: 22319804


NICE (National Institute for Health and Care Excellence)

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